老年腰椎间盘突出症的手术治疗

目的 探讨老年腰椎间盘突出症的特点与手术治疗效果.方法 对62例老人腰椎间盘突出症患者的临床与病理特点进行分析.均行腰椎后路椎板减压髓核摘除术,其中小切口开窗35例,半椎板切除20例,全椎板切除7例,根据手术前后JOA评分评价手术疗效.结果 老年腰椎间盘突出症病理以髓核组织的脱水,纤维环的破裂,小关节囊、周围韧带及软骨终板退变为主要特点.临床特点为下肢疼痛多发,腰部活动受限较多;双下肢神经系统检查肌力下降明显,生理反射改变明显.62例平均随访1.9年,JOA评分术后平均改善率为68.9%,手术前后JOA评分比较差异有显著性意义(P＜0.05).结论 老年腰椎间盘突出症患者病程长,体征多,病理改变明显,行腰椎后路椎板减压髓核摘除术,手术效果满意.     

Early ocular hypertension after cataract extraction

The intraocular pressure (IOP) course during the first postoperative month was measured with Goldmann applanation tonometry in 93 eyes. The patients include 30 eyes of intracapsular cataract extraction (ICCE), 32 eyes of extracapsular cataract extraction (ECCE) and 31 eyes of ECCE combined with posterior chamber intraocular lens (PC-IOL) implantation. The preoperative average IOP was 13.30 +/- 3.24 mmHg in 93 eyes. The first day after cataract extraction was 25.33 +/- 8.18 mmHg and 59 eyes (63.44%) had an IOP higher than 23 mmHg. On the second day it was 16.03 +/- 7.54 mmHg. On the third day it was 14.69 +/- 5.45 mmHg. On the seventh day it was 13.32 +/- 3.44 mmHg and only 2 eyes (2.14%) IOP was higher than 23 mmHg. The first postoperative month average IOP was 12.93 +/- 1.31 mmHg and it was above 23 mmHg in only one eye. When compared with preoperation a significant increase in IOP was found postoperatively. But on the seventh day and after the first month there was no significant difference (P greater than 0.05). The IOP rise among ICCE group, ECCE group and PC-IOL group did not differ significantly.     

肝内HBcAg与血清学指标的关系及慢性乙型肝炎发病机理的探讨

We detected the presence and distribution of HBcAg in the liver by immunohistochemistry (ABC method) and the presence of HBV-DNA in serum (spot hybridization) and anti-HBe in serum (ELISA) from 59 cases of hepatitis B hospitalized in our hospital, including 47 cases of CAH, 5 cases of CPH, and 7 cases of subacute fulminant hepatitis. 1. HBcAg in the liver was detected in 25 out of 47 cases (53%) of CAH, in 2 out of 5 cases of CPH and in 4 out of 7 cases of subacute fulminant hepatitis. The total percentage was 53% (31/59). 2. There was no positive correlation between HBV replication activity and liver disease activity (P greater than 0.05). Our results did not support the hypothesis that suggests a direct cytopathic effect of HBV. Oppositely, the fact was that the presence, the amount and the patterns of HBcAg in the liver, and the presence of HBV-DNA in serum were predominant in mild CAH compared with those in severe CAH, predominant in CAH without cirrhosis compared with those in CAH with cirrhosis. There was a tendency of inverse correlation between HBV replication activity and liver disease activity. The results above were in line with the concept that HBcAg expressed on the surface of infected hepatocytes may be relevant target for T lymphocyte cytotoxicity. The results have suggested that an immune response to HBV is present, leading to the destruction of most infected cells. 3. There was a positive correlation between HBV-DNA in serum and HBcAg in the liver (P less than 0.005), indicating that HBV-DNA in serum can represent HBV replication.(ABSTRACT TRUNCATED AT 250 WORDS)     

ENDOURETHRAL URETHROPLASTY WITH PREPUCE GRAFT FOR LONG POSTERIOR URETHRAL STRICTURE

Twenty patients underwent endourethral urethroplasty with free prepuce graft in combination with transurethral resection of scar for posterior urethral stricture. Two-year follow-up showed that they had good continent and free voiding results. Problems about surgical technique were detailed. We conclude that a free full-thickness prepuce evenly patched by means of the tube balloon to the freshly prepared wound derived from the stricture is the key to surgical success.     

两种检测血清结合胆红素方法的结果比较

[目的]比较2，4-二氯苯胺重氮法（DCA）和钒酸盐氧化法检测血清结合胆红素的结果。[方法]根据NCCLS（EP6-P）评价方案，评估两种方法的相关性和偏倚。[结果]两种方法的检测结果相关性良好（r=0．9985），Ⅰ、Ⅱ、Ⅲ组检测结果无差异，Ⅳ组结果有差异。[结论]应建立与方法学相对应的血清结合胆红素参考值范围。     

不同催眠感受性个体脑电图半球优势的差异

目的:观察不同催眠感受性个体在清醒休息状态和催眠状态下的脑电图半球优势的差异。方法:2003-06/2004-01对成都市6所高校169名正常汉族大学生(四川大学、成都中医药大学、四川师范学院、四川教育学院、成都体育学院、西南民族学院)用斯坦福团体催眠感受性量表C式进行施测,其中总分0～3分为低催眠感受性组,总分4～6分为中催眠感受性组,总分7～11分为高催眠感受性组。进行脑电图测试时,判断受试者是否进入催眠状态标准为:①进入催眠状态:受试者在催眠诱导后的语言抑制、眼皮僵直、催眠后遗忘、左手上浮4个项目的总分为1～4分。②未进入催眠状态:受试者得分为0分。比较进入催眠状态高催眠感受性组和低催眠感受性组在清醒、催眠状态下左、右半球脑电节律的频率指数和振幅差异。结果:参加实验169名学生,斯坦福团体催眠感受性量表C式有高、低催眠感受性的学生56名参加脑电图测试,最后进入催眠状态的50名学生进入结果分析。高催眠感受性29名,低催眠感受性21名。高感受性个体在清醒状态下慢波活动和α-2活动呈现更明显的左侧优势,θ,α,β的振幅呈现更明显的右侧优势,而低感受性个体的慢波活动及振幅没有半球优势;催眠状态下高感受性个体的慢波活动的左侧优势仍更为明显,α波和β波振幅的右侧优势仍更加突出。结论:在清醒状态和催眠状态下,高感受性个体显示出更明显的半球特征性。     

PATHOGENESIS OF EXTRINSIC ALLERGIC ALVEOLITIS AND PULMONARY FIBTOSIS INDUCED BY STREPTOMYCES THERMOHYGROSCOPICUS

There were 48 strains of thermophilic actinomyces isolated from the specimens of mouldy hay and sputum of the patients suffering from farmer’s lung (FL). Streptomyces thermohygroscopicus (STHs),one strain of them, was used for this investigation. The microorganisms were injected into the lungs of rabbits and rats by thyrocrico – or tracheocentesis. The result showed that the pathological changes in the lungs including macrophage alveolitis, granuloma formation and diffuse interstitial were similar to that induced by other thermophilic actinomyces. IgG and C3 deposition in the lesions were also observed by immunofluorescence examination. Specific immunocomplexes in the sera of some animals were detected by ELISA with the STHs was possibly one of the pathogens responsible for FL in China’s countryside.